Shannon,
I know I already posted, but now, 6 months into the job, I have a "new" piece of advice regarding ICU. I went to a specialty ICU- which has turned out great for me, I love neurosurgery, if I had hated it, though, I would have been stuck there. I would recommend starting out in a more general ICU, where you see it all, chest surgery, respiratory failure, big adbominal surgery, liver/kidney failure, CVA, you will see it all, and as you start to work with the patients, you might find a type of pt you especially like. The ICU experience will get you into any specialty ICU, and you will know for sure you like that type of patient.

Great advice hollykate! That is kind of what I was trying to get at with my posting here. You are one of the lucky ones. Many specialty ICU's have contracts to protect all the teaching time they give a new grad which is great for those who end up loving the area but horribly binding for those who don't. Med/surg gives access to almost everything and the experience that goes along with seeing almost everything.

I graduated in April and in May I started working in a level 2 trauma hospital in the ICU. We have one big group of staff that covers ICU in two different levels. We do everything except peds and burns. Those we fly out, the rest we keep. I really like my job because of the variety of patients I get. It is challenging but rewarding. Every year the hospital hires 10 new grads. It is in a very small town of 4,000 people, but it a big hospital. We ahve 33 ICU beds total. There are 3 big towns, Elmira, Binghamton, and Corning NY by the hospital. If anyone is interested let me know! Kimberly Rush, RN

Hi Shannon. Sometimes nurses find the clinical specialty they enjoy right away, or nurses find it by starting in a unit and not liking it. I always knew I wanted critical care, but I had to start in a stepdown telemetry unit. I worked there for eight months and then left to go to the Medical Intensive Care Unit.

There are different schools of thought regarding new grads starting in Med/Surg first before doing specialty, or if they will do fine in specialty with no experience.
I think the answer, from my experiences as a preceptor, largely depends on the individual. I've seen new graduates do just great and others need a longer orientation, and yet others who I really worried about. Your attitude about being open to learning is key--keep and open mind.

Certainly, the first year of nursing is particularly rough. This is the time when you learn the role, and develop your role through your experiences. Some feel the high stress of say, critical care or L&D,may be too overwhelming for new graduates. This is because you need to work on mastering tasks, such as foleys, IVs, etc. Couple having to do tasks and take care of a crashing patient--this can be rough.

The nursing market now is great. We are in a desperate nursing shortage. This means more opportunities are open for you.

Wherever you choose to work, you should educate yourself about the orientation program. You can ask questions during a job interview, find out info beforehand, etc. You should find out what the orientation program consists of for new graduates (i.e, do you have one preceptor or many, do they offer you on-site training/certification, how many weeks of orientation will you get, how are you evaluated).

In nursing school I thought I wanted to work with peds until I got to my pediatric rotation and decided against it. So, some things you'll find out you like/dislike in school. Good luck to you.

I have to reccommend that most all new grads should try to get at least 6 months to 1 year of general medical/surgical experience. Why?? Because this is where you are going to see the "normal" stuff and really understand your patho/phys. Then if you want to specialize you will at least have a good working understanding of what normal is. In today's hospital climate the units see the sickest of the sick and sometimes it's hard to understand how a person has become that patient in the ICU if you have never or rarely seen the events that can or may lead to them becoming critical. Remember we are all in varing degrees of health. It will also give you a good chance to perfect many skills that some units prefer you have under your belt. GOOD LUCK with whatever you do!!!